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    <td width="100%" height="1">
  <h6><font face="Times New Roman" size="3">CỘNG HOÀ XÃ HỘI CHỦ NGHĨA VIỆT NAM <o:p></o:p></font></h6>                  
  <p class=MsoNormal align=center style='text-align:center;word-spacing:0in'><span
  style='mso-font-kerning: 14.0pt'><b><font FACE="Times New Roman">
  <font SIZE="4">
  Độc lập-Tự                  
  do -Hạnh phúc</font></font></b><font FACE="Times New Roman" SIZE="4">       
  <u1:p> </font> </span></p>          
    </td>
  </tr>
</table>

<p class=MsoNormal align=center style='text-align:center;word-spacing:0in'><span
style='font-size: 10.0pt; mso-font-kerning: 14.0pt'><font FACE="Times New Roman">
***************<o:p></o:p></font></span></p>

<h1 align=center style='text-align:center;mso-list:none;tab-stops:.5in'><font FACE="Times New Roman">
<font size="4">ĐƠN XIN CẤP GIẤY PHÉP        
XÂY DỰNG CÔNG TRÌNH VÀ NHÀ Ở ĐÔ THỊ </font><span                
style='mso-font-kerning:14.0pt'>
<o:p></o:p><o:p></o:p>
</span></font></h1>        

<table CLASS="MsoNormalTable" BORDER="1" CELLSPACING="0" CELLPADDING="0"
STYLE="border-collapse: collapse; mso-table-layout-alt: fixed; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; border-style: none; border-width: medium; margin-left: 310.2pt"
WIDTH="172" HEIGHT="1">
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<td width="132" ROWSPAN="2" VALIGN="middle"
STYLE="mso-border-alt: solid windowtext .5pt; border: 1.0pt solid windowtext; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; padding-bottom: 0in" height="1" NOWRAP
ALIGN="center" CLASS="table">
<p CLASS="MsoNormal"><font SIZE="3" FACE="Times New Roman">
Xây dựng mới</font></p>       
<p CLASS="MsoNormal"><font SIZE="3" FACE="Times New Roman">
Cải tạo, sửa chữa<o:p> 
</o:p> 
</font></p>
</td>
<td WIDTH="34" VALIGN="top"
STYLE="mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; border-left-style: none; border-left-width: medium; border-right: 1.0pt solid windowtext; border-top: 1.0pt solid windowtext; border-bottom: 1.0pt solid windowtext; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; padding-bottom: 0in"
HEIGHT="16" NOWRAP>
<p CLASS="MsoNormal"><font SIZE="3" FACE="Times New Roman">
<o:p>
 &nbsp; </o:p>    
</font></p>
</td>
</tr>
<tr STYLE="mso-yfti-irow:1;mso-yfti-lastrow:yes;page-break-inside:avoid">
<td WIDTH="34" VALIGN="top"
STYLE="mso-border-top-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-alt: solid windowtext .5pt; border-left-style: none; border-left-width: medium; border-right: 1.0pt solid windowtext; border-top-style: none; border-top-width: medium; border-bottom: 1.0pt solid windowtext; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; padding-bottom: 0in"
HEIGHT="1" NOWRAP>
<p CLASS="MsoNormal"><font SIZE="3" FACE="Times New Roman"></o:p>
&nbsp;
</font></p>
</td>
</tr>
</table>
<font face="Times New Roman" size="4"><div align="center"></div></font>       

<div align="center">
<table BORDER="0" WIDTH="100%">
<tr>
<td WIDTH="13%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
<td WIDTH="12%">
<font face="Times New Roman" size="4">Kính gửi:&nbsp;</font>           

</td>
<td WIDTH="75%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
</tr>
<tr>
<td WIDTH="13%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
<td WIDTH="12%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
<td WIDTH="75%"><font face="Times New Roman" size="4">&nbsp; - Ủy ban nhân dân&nbsp; TP Vũng Tàu </font></td>
</tr>
<tr>
<td WIDTH="13%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
<td WIDTH="12%"><span STYLE="mso-bidi-font-size: 10.0pt">
<font face="Times New Roman" size="4">&nbsp;</font>       

</span></td>
<td WIDTH="75%">&nbsp;</td> 
</tr>
</table>
</div>       

<p class=MsoNormal style='word-spacing:0in'><font FACE="Times New Roman">
<b STYLE="mso-bidi-font-weight:
normal">1-Tên chủ đầu tư (tổ chức, cá nhân), xin phép xây dựng<o:p>  
</o:p>  
</b><b STYLE="mso-bidi-font-weight: normal">:&nbsp;</b></font></p>        

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Người đại diện (chủ đầu tư) :&nbsp; #INVESTOR_NAME#&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</font></p>  
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">
Địa chỉ liên hệ :&nbsp; </font></p>
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">	 Nhà số : &nbsp; #INVESTOR_HOUSE_NUMBER#&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Ngõ : &nbsp; #INVESTOR_LANE#</font></p>
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">
Đường phố : #INVESTOR_STREET#&nbsp;&nbsp; Xã (thị trấn) : &nbsp;&nbsp; #INVESTOR_TOWN#&nbsp;&nbsp; Quận (thị xã) : &nbsp; #INVESTOR_DISTRICT#</font></p>  
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">
<o:p>
</o:p>
</font><font FACE="Times New Roman" SIZE="4">
Số điện thoại :&nbsp;&nbsp; #INVESTOR_TEL#&nbsp;&nbsp; Fax : &nbsp;&nbsp;&nbsp;</font> <font FACE="Times New Roman" SIZE="4">#INVESTOR_FAX#</o:p> 
</font></p>
<p CLASS="MsoNormal" STYLE="margin-top:6.0pt;text-align:justify"><font FACE="Times New Roman">
<b STYLE="mso-bidi-font-weight:normal">2-Nội dung xin phép xây dựng</b>:&nbsp;</font></p>
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">
Loại công trình : #BUILDING_TYPE# 
  </o:p> 
</font></p>
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Diện tích xây dựng (Tầng 1): #BUIDING_FLOOR1_AREA# m<sup>2<span STYLE="mso-spacerun:yes">&nbsp;&nbsp; </span></sup>Tổng diện tích sàn: #BUIDING_AREA_TOTAL# m<sup>2</sup> </font></p> 
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<o:p>
</o:p>  
Số tầng : #BUILDING_NUMBER_OF_FLOOR#&nbsp; Chiều cao tới đỉnh mái&nbsp; #BUILDING_HIGH# m </o:p> 
</font></p>
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<b STYLE="mso-bidi-font-weight:normal">3-Địa điểm xây dựng</b>:&nbsp; #BUILDING_ADDRESS# </o:p> 
</font></p>
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Lô đất số :&nbsp;#LAND_NUMBER# diện tích : #LAND_AREA# m<sup>2</sup>&nbsp;&nbsp; tại&nbsp; #LAND_HOUSE_NUMBER#</font></p>
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt"><font FACE="Times New Roman">Đường phố :&nbsp; #LAND_TREET#&nbsp;Xã (thị trấn) : &nbsp; #LAND_TOWN#
  </o:p> 
</font></p>
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Quận (thị xã) :  #LAND_DISTRICT#&nbsp; Tỉnh (thành phố) : #LAND_PROVINCE#.
<o:p> 
</o:p>  
</font></p>
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Nguồn gốc đất đai : #LAND_SOURCE# </o:p> 
</font></p>
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<b STYLE="mso-bidi-font-weight:normal">4-Tổ chức, cá nhân thiết kế</b> :&nbsp; #DESIGNER_NAME# </o:p> 
</font></p>
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Địa chỉ :&nbsp; #DESIGNER_ADDRESS# 
</o:p> 
</font></p>
<p CLASS="MsoNormal" STYLE="text-align:justify;text-indent:14.2pt">Số điện thoại : #DESIGNER_TEL# </p>
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<b STYLE="mso-bidi-font-weight:normal">5-Lời cam</b> <b STYLE="mso-bidi-font-weight:  
normal">đoan</b>: Tôi xin cam đoan:</font></p>  
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<o:p>
</o:p>  
&nbsp;&nbsp;&nbsp; - Làm theo đúng giấy phép, thiết kế đã được cơ quan cấp giấy phép xây dựng duyệt.<o:p>  
</o:p>  
</font></p>
<p CLASS="MsoNormal" STYLE="margin-top:6.0pt;text-align:justify">&nbsp;&nbsp;&nbsp; <font FACE="Times New Roman">  
- Có trách nhiệm sửa chữa, bồi hoàn đối với chủ sở hữu các công trình kế cận do việc tiến hành xây dựng công trình gây ra (Lún, nứt, đổ   
vỡ, làm biến dạng công trình .vv.)<o:p>  
</o:p>  
</font></p>
<p CLASS="MsoNormal" STYLE="margin-top:6.0pt;text-align:justify">&nbsp;&nbsp;&nbsp; <font FACE="Times New Roman">  
- Nếu sai tôi hoàn toàn chịu trách nhiệm và chịu xử lý theo quy định của Pháp luật./.</font>&nbsp;</p>
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<p CLASS="MsoNormal" STYLE="margin-top:6.0pt;text-align:justify"><b><i><font face="Times New Roman" size="3">Kèm theo đơn:
        <o:p>
  </font><font face="Times New Roman" size="4">
  </o:p>
</font></i></b> </p>
<p><font face="Times New Roman" size="3"><i>#INCLUDE_DOCUMENT#</i></font>
<p><b><i><font face="Times New Roman" size="3">Giấy tờ khác:
  <o:p>
  </font><font face="Times New Roman" size="4">
  </o:p>
  </font></i></b>
<p><span class="MsoNormal" style="word-spacing:0in">#doc_another#</span>
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<tr>
<td WIDTH="51%" ALIGN="center"><font FACE="Times New Roman" SIZE="3">
<b>Xác nhận của UBND </b></font>
  <p><font FACE="Times New Roman" SIZE="3"><b STYLE="mso-bidi-font-weight:normal">&nbsp;</b><strong>TP Vũng Tàu </strong></font></td>
<td WIDTH="11%" ALIGN="center"></td>
<td WIDTH="89%" ALIGN="center"><font FACE="Times New Roman" SIZE="3"><i>#INFORM_DATE#</i>
</font>
<p><font FACE="Times New Roman" SIZE="3"><b>ĐẠI DIỆN CHỦ ĐẦU TƯ CÔNG TRÌNH<o:p>  
 </b></font></td>
</tr>
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